Study by Georg Marckmann, Corinna Klingler and Jürgen in der Schmitten indicates :
Facilitated ACP has the potential to reduce net costs of care.
The impact on costs of care may depend on the details of the ACP programme.
To protect end-of-life discussions from undue influences of cost considerations, adequate training of facilitators, clearly defined ACP standards and transparency concerning programme objectives and conflicts of interest should be ensured.
Implications for practice, theory or policy
Policy makers might consider investment in professionally facilitated ACP a good use of scarce healthcare resources if safeguards guarantee the openness of the planning process.
Methodologically robust trials are needed to determine which ACP elements are decisive for improving clinical outcomes and potentially reducing healthcare expenditures in accordance with patients’ preferences.
Does facilitated Advance Care Planning reduce the costs of care near the end of life ? Systematic review and ethical considerations. Marckmann G, Klingler C, in der Schmitten J. Palliat Medicine 2016 vol. 30 (5) 423-433.
In Belgium, the PICT tool (Palliative Care Indicator Tool) recently developed by Prof. M. Desmedt and his research team, with the support of the Federal Public Service Health and the three Belgian palliative care federations will :
Identify the palliative patient and perform an earlier ACP.
Define three statuses depending on the severity of needs and adapt accordingly remedial measures.
